Posts filed under ‘Special Rants’
Or…The Real Story Behind the Fight over the ACA
The Afffordable Care Act (ACA) or ObamaCare, as it is often known, is a blessing or a curse depending on whether you are a Conservative or a Progressive. While counterintuitive, the short-term economic objectives of the two camps are directly at odds. And, until there are more money machines on the horizon, we can expect Republicans to cling to their myopic market view. The trouble is…healthcare that is not allowed to keep us well efficiently will ultimately kill us in the economy, too.
Democrats and Republicans draw opposite conclusions from the same data on healthcare. And the harder the Progressive Democrats try to demonstrate that the facts are on their side with the ACA…the more the Republicans persist in their push for its repeal.
The ACA is reaching uninsured Americans, providing them healthcare, and lowering the inflation rate for that healthcare…all at the same time. And adding healthcare benefits for millions of workers has co-existed with jobs growth and lower unemployment across the US, the exact opposite of the doomsday predictions that bolstered Conservative opposition to the ACA. Where’s the bad news in that?
Well, if you are a Republican and all you have to show for your three decades of alleged supply-side economics is growth in the healthcare and real estate markets, efficiencies in either sector cause damage to their world views. My health economics rant from a few years ago summarized how healthcare costs crowd out other investments in our economy, yet are paradoxically embraced by conservatives because of all the short-term benefits of stock performance, employment, and strong multipliers.
For Conservatives, it is the story of the Goose that Laid the Golden Egg. For the rest of us, there is a sequel…the Goose that Ate Its Own Golden Egg.
There is no good end game to allowing healthcare to crowd out the rest of the US economy. And turning healthcare into a privilege that is inaccessible to growing numbers of Americans can only be seen as a failure in the market. But there seems to be no easy way to get Republican Congressmen, who are up for election every two years, to put aside their reading glasses and see the danger that lies ahead.
We need non-health-related investment opportunities to replace the healthcare sector as stock market darlings. And we need our keepers of capitalism to open their eyes to this need rather than clamoring to hang onto market inefficiencies in healthcare that are unsustainable. In the meantime, we must turn our disbelief into cynicism and add education about the future of our economy without management of the healthcare monster to the charts on the ACA. It probably won’t penetrate the collective consciousness of the Conservative brain distrust, but it may help motivate us keep our eyes on the prize in this very important battle for a strong economy and a healthy populace.
We may have crossed a line without knowing it. Politicians may be selling influence on the international markets without a trace of evidence through political action committees (PACs). And the appearance of conducting foreign affairs out of Legislative offices suggests a breakdown of the separation of powers owing to the Executive branch. This would seem like a case for the Supreme Court…if only they had not caused the problem in the first place.
Whoever is the keeper of the US Constitution is doing a shoddy job. Corporations and wealthy power brokers already have exerted undue influence over our democratic process with the blessings of a conservative majority on the Supreme Court. Once blurred, the lines of campaign finance may have been crossed again in the last Presidential election when Mitt Romney made three high-profile stops overseas for “fund raisers” in which “only the American participants” were allowed to write the checks. One of the stops was Israel, where Mr. Romney assured all in attendance that he would support the military decisions of the Israelis were he to be elected President of the United States. Fortunately, that promise was not put to the test.
Now Israel’s Prime Minister has been invited by the Speaker of the House to address Congress on his concerns over the State Department’s negotiations with Iran over nuclear weapons. And a group of US Senators has sent a letter to Iran warning that the next US President could overturn treaties with great efficiency.
It is time to start looking for the money trail. If this is treason…it must end now.
High school special educators know a lot of students who ultimately identify in the LGBT community…students who are trying to shelter-in-place in a small group setting after the very traumatic experience of trying not to be themselves for a very long time. They often are medicated for ADHD and offered therapy for counter-intuitive behaviors in which they indulge in hopes of being accepted among students who identify as straight. PTSD is not just for warriors.
We don’t talk about this, but I wish someone would study it (maybe they have?)…so we can be informed and address it more appropriately. But I truly believe that there are a significant number of students among the Special Needs population who are misdiagnosed. They are anxious, appear hyperactive, have difficulty focusing in school, act on impulses that get them in trouble, and accept punishment in a manner that suggests self-loathing. They also are very bright and can think fast, produce fabulous school work, and excel in most endeavors in a very safe place. Let’s call their disability Post-Traumatic Stress Disorder, or PTSD, for kids whom life had taught to wish they were someone else.
I want to say it is okay…you are going to be alright. And no, we cannot find the person who did this to you and made you different, but you are beautiful. But that often is not what the student who is engaged in an internal battle over his or her identity seems ready to hear, especially from an adult who could not possibly understand what a teen is going through. And the rest of the world is making some progress, but it is not fast enough. In the meantime, unnecessary pain and suffering continues as students try to recede among the wallflowers or jump out of their own skin in search of sameness with everyone else.
What can we do to create an authentically safe place in school? And what can we do to advance the cause of acceptance in the work place, on a park bench, or in the retail dressing room or public restroom? Sadly, our students expect the worst. And for some that becomes a self-fulfilling prophecy. But it might help to stop adding the Special Ed label and misguided interventions to an anxiety disorder that we might just be perpetuating. I am happy to offer a safe place. Just wish it were not a stop-gap measure for an all-too-imperfect world.
We are in hard times. Our economy is stagnant and beholden to offshore producers. Our money is in the hands of thugs in starched white shirts. Our Constitution is in the hands of angry men and corrupt judges. Our children are not being served with equity, and we can only promise them less than we inherited on this earth. Now we have to face injustice that does not value the lives of children of color. How can we de-escalate our struggles and find ourselves as Americans again, perhaps for the first time?
We have returned to the land of the zero-sum society. Everything I get must be taken from someone else, and everything you get has been taken from me or mine. The only business at hand is sorting “We The People” into the “Us” or “Them” columns. Then, armed to the teeth with weapons of war and misinformation, we protect ourselves and undermine them with impunity. This is NOT America.
We do not need anyone trying to take back America. It does not belong to just some of us. We need to find America in hard times and make it work for all of us. We have a constitution – giving life, liberty, and pursuit of happiness to all of our people. It is not a weapon, it is a covenant.
The flashpoint has been struck with the death of a third person of color at the hands of a white man who got away with it. We have exposed the dark underbelly of racism at the heart of our justice system. And we cannot turn away from it. Apparently we have not fully eradicated the most crucial flaw of our founding fathers…the valuing of a human being at some percentage less than 100 based on the color of his skin.
We are not at rest, and we cannot be at rest until this issue is resolved. However, we can use our humanity to set things right by coming together as people who believe in our common rights of man, or we can allow a conflict to escalate and be decided in a battle of Americans against one another.
The road to finding America lies ahead of us, and we can only come together by setting all else aside for a moment. Turn off Fox News, and that iPhone. Stop worrying about that pension fund. Put down that gun, and tell your lawyer he or she is off duty…because each of us must be stripped bare of who and what we think we are. Only then can we find our places in a fair and just society that is inclusive of all of mankind.
We can take a trip up Maslow’s hierarchy. Are we all warm, and safe, and dry? Have we all been fed? Do we have access to good work, good health, and safe travels? Can we exercise our minds, develop our talents, and take leisure with gusto? And, then, can we achieve the vision to save our world and create the constructs to realize the dreams of others as with our own.
Paradigm shift is just another name for structural change in the marketplace. In the case of the Internet revolution, there have been seismic shifts in two out of four parts of the market at once…promotion and channels of distribution. The product and the price seem not to have been affected as much. Still, the technology upheavals have blown such a smoke-and-mirror show in the faces of the Wall Street pack that they have lost their vision for the future. A renewed interest in shareholder value is our only hope.
Flipping something in the market is fool’s gold. It is not even a zero-sum game, because as long as nothing remains in the long run except the fees paid to the brokers we will all be worse off. It triggers a slow downward spiral that cannot ever pay off in net, and, by the time anyone seems to notice it, the damages have already hit a dangerous level of acceleration.
So go the bubbles on Wall Street. Yet the world markets have been satisfied to ride the wave of a series of rising and falling tech stocks based on fads that hold the attention of the masses at any given time. “Getting” the new paradigm seems to presume that fundamentals no longer matter. Besides, no one under 30 has a prayer of a chance of connecting the words shareholder and value to anything meaningful.
The ugly secret to this game, besides its inherent uselessness, is that the only winners are insiders…not just fee-collectors, but the fund managers who have the clout to cheat and the arrogance not to care. Ironically, they are the keepers of capitalism, an economic game at which they totally suck!
Capitalism may have greed as its motivation, but it is not its own end game. And true capitalists wish to sustain themselves. Captains of industry build businesses that are meant to offer lasting shareholder value. They make real products, have a genuine competitive advantage, and reinvest profits in a research-based pipeline of next generation products to stay viable. They do not invest in 19th century work conditions in third-world countries and sit on their offshore profits while lobbying for yet another round of tax relief.
Yeah…this falls under the heading of Special Rants. I went to business school and worked in finance once upon a time. I got interested in education as a problem-solver. Yet one of the most frustrating aspects of education reform is the ability of tech toolies to continue to manipulate educators like kittens stalking a laser beam with newer and better apps while we continue to ignore our own fundamentals. Flipping through fly-by-night pedagogical tools is not reform.
Systemic change in education is not just possible, it is essential. We have the ability to use technology to eliminate obstacles to broad-based pedagogy and to inform ourselves with real data about finance, student outcomes, and educator effectiveness. Reinventing the business systems behind education can free us from the mythology that keeps educators trapped in myopic visions of success, dysfunctional management, and service to the bureaucracy instead of the mission of educational excellence.
Supply-side economics should have fueled a booming revitalization of our capital stock in the US. Instead the savings of a generation got invested in outsourcing, pooled in offshore profits, and used to reward 19th century working conditions in emerging producer-nations. And when too much money was still sitting around within our borders, it funded tech bubbles and financial risk games. Badly done, fiscal conservatives.
I am a fan of Occupy Wall Street. I believe that the keepers of capitalism have failed us. But I also believe that they have failed to practice capitalism. Instead of investing money in assets that create shareholder value, jobs, and an economic success cycle…Wall Street rewarded net divestiture of the of the supply function in the US. And they spent the proceeds on non-productive paper assets. This is pseudo-capitalism, where money goes to die.
Amazingly, we still have idle cash on the corporate books. We do not need more supply-side economic incentives. We won’t be fooled with that claim again. But we still have a great deal of uncertainty on 21st century capitalism. The trade deficit teaches us that we must develop our factors of production domestically. But we seem not to have a vision for private industry in the US.
As a nation, we can do almost anything well. But what can we do competitively while being clean and green and paying living wages? We really have got to figure this out.
(PS, Privatizing government services doesn’t count…might as well try paying for them with taxes on repatriated profits. And only getting a rare tax break on said profits after they turn into new industrial payroll dollars domestically.)
Transgender men and women often find themselves stymied halfway through transition. Historically, hormone therapy and swapped out wardrobes marked the end of physical change, the goal being to look good enough to face society and hold down a job. The new frontier, however, is gaining access to bona fide gender reassignment and life in a much larger world. It doesn’t have to feel like the search for the Holy Grail…a little help, please.
Being the strong person in a marginalized community carries a heavy weight. Admirers gather because they think you’ve got it made, and they want to learn how to get there themselves. They come with a bottomless pit of need; if only they could feel like you do. They lose sight of the fact that you have the same fears they have, that you hate your body, and that you believe you were somehow marked for pain with no relief in sight. This is definitely not as good as it gets…but even your allies are pulling you down and keeping you from clarifying that vision of your future that will make it all worthwhile.
Many people crater emotionally after achieving milestones in their lives. Depression, if a recurring theme, is exhausting. The search for life and enduring love is at best sweet and sour. And success often gets redefined by the next challenge before one can fully enjoy an emerging victory. For a person going through gender transition, that trifecta is completed by an official diagnosis of gender dysphoria. Hurray…you are officially in the wrong body. Now what?
Gender reassignment remains controversial, mostly due to ignorance. Would-be supporters fear the costs, forgetting that all the data available is exaggerated by the burden of a long history of predatory pricing. Conscientious objectors often overlook that they defined deities and wrote the books on right and wrong as mere mortals who had not yet discovered the limbic system in the brain. Political fanatics decry the day that their government will force its citizens “to pay for sex changes for confused illegal aliens…” while they send their kids off to denial camps. Get a grip, guys. Someone’s life got too complicated a while ago; we can help sort it out if we get out of our own way.
The path to accessible and affordable gender reassignment is not so complex. It simply depends on…
- Acceptance of transgender status and the appropriateness of medical and surgical intervention for gender reassignment;
- Protocols for gender transition with combined physical and psychosocial supports;
- Coverage in health insurance plans:
- Establishing maximum allowable charges for procedures and other therapies,
- Making contributions toward coverage with reasonable copayments or coinsurance, and
- Screening providers for quality assurance and maintaining networks of caregivers for enrollees in need of transgender services; and
- Ensuring safety nets for those unable to pay for health insurance.
Broader access to care does not have to be financially catastrophic to individuals or 3rd party sponsors of healthcare financing. Inclusion of transgender procedures in insurance contracts would quickly eliminate much of the predatory pricing that characterizes the field. In addition, while there may be significant pent-up demand for transgender services, this would be a temporary phenomenon. In fact, employers who offer transgender coverage often report lower than expected initial demand.
Finally, appropriate healthcare for a transgender person cannot depend on personal wealth or employment. These two factors are inextricably linked and, often, neither is available in the midst of gender transition. Many transgender people have a very difficult time securing employment, and initial hormone therapy and cosmetic procedures rapidly exhaust personal savings. The surgical process may interfere with the patient’s ability to sustain employment due to complex, iterative procedures and the dearth of work places that offer true safe harbors for trans employees. In the meantime, the process of personal grooming each day, negotiating safe passage from home to the workplace, and achieving acceptance by their peers remains a devastating burden. No, this cannot be as good as it gets.
Note: This is the third in the series of Special Rants under the heading of Transgender Trilogy, a very personal cause that became unavoidably compelling after the recent death of my stepdaughter whose life as a transgender woman overwhelmed her. Posts #1 The Search for Life After Gender Transition & #2 A Useless Lament